During the past 35 years, the roles for nurse practitioners (NPs) and physician assistants (PAs) have evolved in parallel with the roles that physicians have come to play. Shifting needs in primary care and expanding opportunities in specialty medicine have been the dominant trends. Future directions will be influenced additionally by the deepening physician shortage. NPs are preparing for this...

Attempts to reduce the problem of tuberculosis through organised efforts had their beginnings in India in the late thirties. With the introduction of chemotherapy, organised home treatment of tuberculosis from the TB clinics, situated mainly in cities and district headquarter towns, was started. The mass BCG campaign, started in 1951, gave the first indications that the problem of tuberculosis ...

Context The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content Progress has been uneven, historically punctuated most dramatically by the Cultural ...

In April 2006, Massachusetts enacted a comprehensive health care reform bill that seeks to move the state to near universal insurance coverage. The bill included expanded eligibility for public coverage, subsidized insurance, market reforms, requirements for employers, and, most controversial, an individual mandate. A study of the early impacts of the state's initiative found evidence of a subs...

Palliative care is an important component of cancer treatment. Advancing palliative care in the developing countries is essential to improving patient care. The issues limiting its practice must be addressed, especially in light of the initiative to adapt the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) to the Middle East and North Africa (MENA) region. Palliative care is in ...

OBJECTIVE From a perspective of comprehensive care, the purpose of the study was to evaluate factors associated to dental care provided to Down syndrome children and adolescents. METHODS A cross-sectional study was carried out including 112 pairs of mothers/Down syndrome children aged between 3 and 18 years who attended a public hospital genetics clinic in Rio de Janeiro, Southeastern Brazil,...

This study aims to understand the production of comprehensive care in prenatal care in a Basic Unity of Family Health in Fortaleza. To this end, we conducted semi-structured interviews with a user, whose prenatal care was provided by a Basic Unity of Family Health, as well as systematic observations of her prenatal care appointments. Data analysis, conducted according to Merhy’s analytic flowch...

Federally qualified health centers and small primary care practices have many challenges in common: uninsured patients; growing numbers of chronically ill patients with complex needs; inadequate reimbursements by commercial health plans; and persistent staffing problems. Smaller primary care practices also face sizable barriers to participating in new delivery and payment models that are likely...

We sought to identify and understand the health care needs of young people living with HIV/AIDS, particularly in terms of their psychosocial well-being. We conducted a qualitative analysis of HIV-positive young people and their caregivers, focusing on the implications of an HIV diagnosis for health care needs. Stigma was a recurrent issue that arose in the interviews conducted with the responde...

OBJECTIVE To determine whether the original continuity of care framework is still applicable to family medicine today. DESIGN Qualitative descriptive study. SETTING Kingston, Ont. PARTICIPANTS Three groups of first-year family medicine residents (18 in total), 2 groups of family physicians in established comprehensive practices (9 in total), and 2 groups of family physicians working in ep...